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Physical exercise as a modulator of the purinergic system in the control of sarcopenia in individuals with chronic kidney disease on hemodialysis

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Abstract

The word sarcopenia derives from the Greek terms “sarx” for meat and “penia” for loss, thus being used to define reductions in muscle mass, muscle strength, and lower physical performance that compromise, mainly, the elderly population. Its high negative impact on patients’ quality of life encourages the production and publication of new studies that seek to find methods to prevent and reverse cases of loss of muscle mass and strength. Furthermore, the high prevalence of sarcopenia in patients with chronic kidney disease (CKD) is closely related to its pathophysiology, which consists of a state of increased protein catabolism and decreased muscle tissue synthesis. Also considering the inflammatory nature of CKD and sarcopenia, the purinergic system has been an important target of studies, which seek to relate it to the two previous conditions. This system achieves anti-inflammatory action by inhibiting, through adenosine, pro-inflammatory factors such as interleukin-12 (IL-12), tumor necrosis factor alpha (TNF-α), and nitric oxide (NO), as well as by releasing anti-inflammatory substances such as interleukin-10 (IL-10). Simultaneously, the purinergic system presents pro-inflammatory activity, signaled by adenosine triphosphate (ATP), which occurs through the activation of T cells and the release of pro-inflammatory factors such as those mentioned above. Therefore, the ability of this system to act on inflammatory processes can promote positive and negative changes in the clinical aspect of patients with CKD and/or sarcopenia. Furthermore, it appears that there is a correlation between the practice of repeated physical exercise with the clinical improvement and in the quality of life of these patients, presenting a decrease in the levels of C-reactive protein (CRP), NTPDase, and the pro-inflammatory cytokine IL-6, such as increases in IL-10 resulting from modulation of the purinergic system. In this way, the present article seeks to evaluate the effect of physical exercise as a modulator of the purinergic system in the control of sarcopenia in patients with CKD on hemodialysis, in order to trace a relationship that can bring benefits both for biological markers and for quality of life of these patients.

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Funding

FAPESC-Research Support Foundation of the State of Santa Catarina.

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Authors and Affiliations

  1. Department of Graduate Studies in Biomedical Sciences, Federal University of Fronteira Sul (UFFS), Rodovia SC 484-Km 02, Fronteira Sul, Chapecó, SC, CEP 89815-899, Brazil

    Débora Tavares de Resende e Silva

  2. Department of Medicine, Federal University of Fronteira Sul (UFFS), Chapecó, Santa Catarina, Brazil

    Matheus Ribeiro Bizuti, Natan Rodrigues de Oliveira, Lucas Zannini Medeiros Lima, Victória Galletti dos Santos Arraes, Ana Carolina Gonçalves Zietz, Carolina Zin & Guilherme Vinício de Sousa Silva

  3. Department of Health Sciences, Western Santa Catarina University, Videira, Santa Catarina, Brazil

    Josiano Guilherme Puhle

  4. Nursing College, Federal University of Fronteira Sul (UFFS), Chapecó, Santa Catarina, Brazil

    Fabiana Brum Haag

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  1. Débora Tavares de Resende e Silva
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  2. Matheus Ribeiro Bizuti
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Contributions

G.V.S.S., M.R.B., and D.T.R.S. contributed to the conception, project administration, and supervision. N.R.O., L.Z.M.L., V.C.G.S.A., A.C.G.Z., C.Z., and J.G.P. contributed to the formal analysis, investigation, and methodology. D.T.R.S. supervised the methodology. G.V.S.S., M.R.B., and F.B.H. contributed to the writing and translation of the original draft. M.R.B. and D.T.R.S. revised the final work.

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Correspondence to Débora Tavares de Resende e Silva.

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de Resende e Silva, D.T., Bizuti, M.R., de Oliveira, N.R. et al. Physical exercise as a modulator of the purinergic system in the control of sarcopenia in individuals with chronic kidney disease on hemodialysis. Purinergic Signalling (2023). https://doi.org/10.1007/s11302-023-09950-1

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